The Misunderstood Child

1. The Misunderstood Child Understanding and Treating the Child with Sensory Processing Dysfunction in the Library Setting

2. Presentation Outline • What is sensory processing and how does it affect learning? • What are some classic symptoms of sensory processing disorders? • What may be done in different environments to improve sensory processing? • What are the benefits of meeting sensory needs? • How can libraries incorporate sensory strategies?

3. Sensory Processing • Definition: “Sensory Integration is the organization of sensation for use.” Ayres. • Important aspect of normal brain function, enabling us to make sense of many different kinds of sensastions coming into the brain along different sensory channels at the same time. • The ability to make adaptive responses is dependent upon sensory processing.

4. Sensory Integration • Is the ability to take in, sort out, and connect information from our environment. • Takes place automatically in normal development as information is taken in through the senses. • Is the process by which the central nervous system develops and matures. • Is developed and/or enhanced by sensory experiences.

5. Sensory Integration Dysfunction • Difficulty with the CNS processing of sensation, especially vestibular, tactile, or proprioception, which is manifested as poor praxis, poor modulation, or both (Bundy et al, 2002). • Common symptoms include: sensitivities, emotional outbursts, avoid/seek movement, high/low activity level, distractibility, poor motor planning, decreased bilateral coordination, difficulty with transitions.

6. Sensory Defensiveness • May be sensitive to sounds, sights, movement, smells, etc • Common problem in children with ASD • Barrier to everything else • Characterized by exaggerated responses • Unpredictable emotional outbursts

7. Sensory Modulation • Problem of brain chemistry (neurotransmitters dealing with arousal) • Can see the escalation building • Over/under arousal • Shut down • Fluctuating arousal

8. Power Systems • Vestibular • Proprioceptive • Tactile • Auditory

9. Vestibular • Location of receptors (inner ear) • Responds to movement of the head and input from other senses • Function: provides information about where our body is in space, whether we are moving or our surroundings are moving, and which direction • Powerful influence on arousal level

10. Clinical Implications • Can’t sit still • Fidgety • Stands or moves often • Seeks movement • Refuses movemement

11. Proprioceptive • Receptors located in muscles and joints • Gives us our body content • Activated by active movement (best with resistance) • Function is to give information to the brain about where body parts are and what they are doing without thinking about it

12. Clinical Implications • Difficulty sitting squarely in chair: slips out, wraps feet • Hold pencil too lightly/tightly • Crash into objects/people in the environment • Not able to do things without looking

13. Clinical Implications • Stands up to work/learn • Lays on floor or table • Generally inactive • Frequent hitting, hugging, pushing, squeezing, pinching

14. Tactile • Gives me body boundaries • Powerful effect on emotions • Alerts us to threat • Basis for body image • Two systems (light touch/deep touch)

15. Clinical Implications • Poor tactile discrimination • Tactile defensiveness • Problems that accompany: Dyspraxia Hyperactivity Oral defensiveness Attention deficits Articulation difficulties Decreased visual perception

16. Sensory Modulation • Intake of sensation via sensory processing such that the degree, intensity, and quality of the response is graded to match the demands of the environmental situation and so that the range of optimal performance/adaptation is maintained (Wilbarger, 1998).

17. Sensory Modulation Disorder • Problems grading responses • Problems attaining or maintaining optimal range of arousal • Unusual patterns of sensory seeking or avoidance • Difficulties with emotional regulation (anxiety, depression) • Attention difficulties including distractibility, disorganization, impulsivity, and hyperactivity • Poor social participation, insufficient self-regulation, and poor self-esteem

18. Low Arousal • Under reactive to sensory input • Couch potato • Hard to initiate • Dysparaxia • Decreased motor planning • Hard to get going • Obligated to gravity • Low tone bias • Slow to process/slower response time • Collapsing into gravity • Decreased rotation • Short/shallow breathers • Difficulty getting to sleep/waking up

19. Narrow Band of Optimal Arousal • All or nothing • Can’t regulate/can’t grade • Can’t figure out how to stay in the right place/often don’t recognize optimal when they are there • On or off/ping pong • When on they hit the ground running • Difficulty with transitions • Poor appetites • Fast motion • Overshoot • Move/seek sensation • Often on Ritalin • Biased toward quick/phasic movement • Often walked early • Short/shallow breath • Posture up/eyes up and out/upper chest breathing

20. Defensive • Tactile issues • Feeding issues • Discriminate too well • Inability to recover • Biased towards extension • Poor regulation with breath • Stuck in monitor • Car without brakes • Hard time coming to center

21. Shutdown • Overloaded • Can put me in the picture (often shut things off) • Often decreased response to pain • Frozen breath pattern • Can’t get internal rhythms • Slept too much as a baby • Not available • Somebody else is driving

22. Sensory Diet Just as a child’s body needs an appropriate nutritional diet to support bone and muscle growth as well as maintain health; a child also needs an appropriate sensory diet to promote efficient processing of sensory input and to maintain balance in the nervous system.

23. Oral Motor Input • We all use our mouths to organize • Helps to concentrate • Sucking can be calming • Alerting tends to be cold, sour, tart, spicy • Calming tends to be warm, smooth, sweet • Heavy work foods alert and calm

24. Vestibular • Bean bag chairs, rocking chairs • Slow, rhythmical movement is calming • Fast, arhythmical is alerting • Chair push-ups, balls, t-stools

25. Auditory • Music with a defined rhythm and beat can facilitate movement and help with transitions • Minimize auditory distractions • Speak clearly and give time to respond • Social story for library behavior

26. Space • Have a smaller space that is not as overwhelming and minimizes distractions • Have “womb” space • Have “kid space”

27. Brain Toys/Fidgets • Silly putty • Koosh balls • Hair elastics • Bender rods • Pipe cleaner